Provider Demographics
NPI:1750390829
Name:ADVANTAGE HEALTHCARE SERVICES - DME LLC
Entity type:Organization
Organization Name:ADVANTAGE HEALTHCARE SERVICES - DME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEGLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-706-9030
Mailing Address - Street 1:17011 BEACH BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7421
Mailing Address - Country:US
Mailing Address - Phone:714-706-9030
Mailing Address - Fax:
Practice Address - Street 1:27800 MEDICAL CENTER RD STE 99
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6415
Practice Address - Country:US
Practice Address - Phone:949-364-0122
Practice Address - Fax:949-347-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
CAPHY515513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141657OtherPK
7376900001Medicare NSC